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General NPI Number Information
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NPI Number | 1063679140
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Entity Type | Individual
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Provider Name | SUSANNA KOVARI M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/17/2008
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Last Update Date | 05/13/2024
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Provider Practice Location Address
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Address Line | 660 BANNOCK ST
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City | DENVER
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State | CO
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Zip | 80204-4506
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Country | US
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Telephone | 303-602-8270
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Fax | 33-602-8277
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Provider Business Mailing Address
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Address Line | 777 BANNOCK ST
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City | DENVER
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State | CO
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Zip | 80204-4597
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Country | US
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Telephone | 303-602-8270
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Fax | 303-602-8277
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036124201
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036124201
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0060681
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License Number State | CO
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